Healthcare Provider Details

I. General information

NPI: 1376202259
Provider Name (Legal Business Name): NATALIE LEIBFREID BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2021
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

527 ALLEN ST
OWENSBORO KY
42303-3437
US

IV. Provider business mailing address

527 ALLEN ST
OWENSBORO KY
42303-3437
US

V. Phone/Fax

Practice location:
  • Phone: 270-240-1842
  • Fax:
Mailing address:
  • Phone: 270-240-1842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number307801
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: